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Wisconsin health insurance premiums higher than national average

By Scott BauerAssociated Press

Posted:
09/25/2013 12:01:00 AM CDT

Updated:
09/25/2013 06:20:48 PM CDT

MADISON, Wis. -- Wisconsin residents will pay more than the national average for health insurance purchased on the federal exchanges, according to information released Wednesday by the Obama administration.

The state's average monthly premium costs are 14th highest based on information from the U.S. Department of Human Services that compared weighted average premiums among 47 states and the District of Columbia.

A mid-range benchmark insurance plan for an individual in Wisconsin will cost, on average, about $361 a month -- $33 more than the national average. The plans range from a low of $192 in Minnesota to a high of $516 in Wyoming.

Costs revealed Wednesday do not take into account tax credits residents may be able to receive. Premiums will also vary based on an individual's circumstances, including where they live, the level of plan picked, family size, age, income and tobacco use.

Starting Tuesday, Americans can begin enrolling for coverage under plans sold through online health insurance marketplaces, also known as exchanges. In Wisconsin, about 400,000 uninsured people and about 92,000 losing their BadgerCare Medicaid coverage will be shopping for plans through the state's exchange.

The coverage begins in January, when everyone will be required to have health insurance or face a penalty.

Gov. Scott Walker, an opponent of Obama's health care law, deferred to the federal government to set up the exchange.

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Earlier this month, his administration released data showing the difference between the current rates and the exchange rates for what individual coverage will cost for a plan with a $2,000 deductible and prescription drug coverage. Its analysis showed rates would increase, depending on a person's circumstance, from 9.7 percent to 125 percent.

Just as advocates of the federal law criticized the data from Walker's administration for not accounting for a host of circumstances, Walker's spokesman found fault with the HHS information.

"The numbers released today by the federal government are limited, offering no comparison to current rates," Walker spokesman Tom Evenson said in an email. "There is still much left to be learned from the federal government on this."

J.P. Wieske, a spokesman for the insurance commissioner's office, said it was difficult to compare the new data with what his office released, given the variables.

The HHS data showed consumers will be able to choose from an average of 53 plan options nationally. In Wisconsin, there will be an average of 97 plans available. Lawmakers keyed the tax credits to the cost of the mid-range silver plans, or benchmark, plans.

Consumers can pick from four levels of coverage, from bronze to platinum. All the plans cover the same benefits and cap annual out-of-pocket expenses at $6,350 for an individual, $12,700 for families.

The big difference is cost-sharing through annual deductibles and copayments. Bronze covers 60 percent of expected costs; silver 70 percent, on up to platinum at 90 percent. Bronze plans have the lowest premiums and the highest cost-sharing.

According to the federal report, premiums for the lowest-cost silver insurance plans will average $344 a month for individuals in Wisconsin compared with $310 nationally. The lowest-cost bronze plans will average $287 monthly -- $38 more than the national average for similar coverage.

For a family of four with an income of $50,000, according to the federal report, the benchmark silver plan will average $861 monthly in Wisconsin before any credits -- the price drops to $282 a month with subsidies.

The most expensive area to buy insurance in Wisconsin will be on the Minnesota border in Pierce, Polk and St. Croix counties: $348.02 per month for an individual.

The least expensive area to buy insurance will be in eastern Wisconsin, where the benchmark plan will cost an individual $198.65 per month in Calumet, Dodge, Fond du Lac, Outagamie, Sheboygan, Waupaca, Waushara and Winnebago counties.